[Management strategies and research progress in pancreatic fistula after pancreaticoduodenectomy].

Abstract

Pancreaticoduodenectomy is the standard surgical procedure for treating malignant tumors in the head and neck of the pancreas, the uncinate process, the ampulla of Vater, and the lower segment of the bile duct. The operation involves multi-organ resection and complex gastrointestinal reconstruction. Pancreatic fistula is a common complication after pancreaticoduodenectomy, often leading to infections, bleeding, and other complications, which can result in perioperative mortality. In recent years, with advancements in surgical techniques and concepts, as well as close collaboration among multidisciplinary teams, the management of pancreatic fistulas following pancreaticoduodenectomy has become increasingly optimized. Key aspects such as early identification, adequate drainage, nutritional support, inhibition of exocrine pancreatic secretion, infection control, and timely reoperation are all crucial in managing postoperative pancreatic fistulas. However, the current strategies for managing pancreatic fistulas, while clinically applied, are essentially symptomatic supportive treatments. There is currently no definitive treatment that can heal pancreatic fistulas within a short period. Therefore, there is an urgent need for significant progress in basic research and the translation of new materials to provide new strategies for managing pancreatic fistulas after pancreaticoduodenectomy.